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Family Christian Academy
Program
Enrollment Date

MonthDayYear
Date
Please select the school year you are enrolling and submitting payment for. If you are paying a past-due enrollment fee from a previous school year, please be sure to select that specific year.
School Year*

23/2424/2525/2626/27

Type of Enrollment*

New Enrollment (Never been enrolled)Re-Enrollment (Enrolled last year)Returning Student (Previously enrolled with FCA, transferred out and now returning)
Student Name*

First NameMiddle NameLast Name
Student Gender*

MaleFemale
Grade*
Student D.O.B*
MM/DD/YYYY
SSN
555-55-5555
Address*

Address

Street Address Line 2

CityState

Zip
County*
County.*
(Not country)

You must provide a valid school fax number or email address to request records. Please contact your previous school and ask for the best fax and/or email for records requests. Records will not be requested without this information.
Previous School Attended*
Not Applicable
Previous School Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Previous School Phone*
Previous School Fax
Previous School Email*
example@example.com

IMPORTANT:
Submission of this enrollment form acknowledges that...
You have read and agreed to Family Christian Academy's Policies.
You understand that submitting any false information will result in the immediate nullification of this enrollment.

FCA does not provide refunds for services.
How many students in this family have already been enrolled for the selected school year?
Parent/Guardian Signature*

Clear
Coupon Code:
Enrollment:
Early Discount:
New Student Processing:
Card Processing:
Total:

Checkout

USDDescription

Credit Card

Apple Pay

Google Pay

Cash App Pay

ACH Bank Transfer

Afterpay